Pioneers of Surgery

Ever wondered just how modern medicine got to where it is today? This generation of miracle makers was preceded by those who dared. Furthering technologies that make today's work possible wasn't always easy and this series pays tribute to those who made modern science evolve.

CHLOROFORM: AN INSTANT HIT

Before the discovery of chloroform and ether, early anesthetics included alcohol and opium. In fact it has been suggested that Greeks and Romans used opium as painkillers for operations, while cannabis was known to be used in the Middle Ages. Chloroform gave surgery a new lease of life, allowing surgeons more time to work. Discovered in the 1830's, chloroform was an immediate success: sweet, pleasant and not as flammable as other anesthetics. It was first used in an obstetric case on November 8, 1847 in Edinburgh. It's potency knocked out patients to such an extent one 12 year old girl simply remarked "Oh! Is it off?" when she saw her leg has been amputated. And it was even good enough for Queen Victoria's labour!

A HISTORY OF BLOOD TRANSFUSIONS

The first blood transfusion recorded back in 1492 on Pope Innocent VIII didn't work out quite as planned. Following an apoplectic stroke, his physician performed a transfusion, but crude methods lead to his death. By 1665 the first successful dog to dog transfusions were conducted, but it wasn't until 1818 that James Blundell, a British obstetrician conducted the first successful human blood transfusion from husband to wife. Only in 1901 did Karl Landsteiner, who later received a Nobel Prize for his work, discover the individual blood types splitting them into groups: A, B and O, finally explaining the why and how of successful blood transfusions.

BROKEN HEARTS NEED FIXING

The first insights into heart surgery came in the wake of the World War II when, Dr. Dwight Harken, a U.S. Army surgeon looked at ways to remove shrapnel fragments in soldiers' hearts. Experimenting with animals first, Harken aimed to develop a technique that would enable him to get into the wall of a beating heart, and remove shrapnel with his fingers. After testing methods on three groups of 14 animals, he felt ready to try it on humans. Amazingly, all his patients survived, thus showing that human hearts could indeed be operated on 'live'.

HIBERNATING HEARTS

By 1952, Dr. Walton Lillehei and Dr. John Lewis, two University of Minnesota surgeons, carried out the first successful open heart surgery on a five-year-old girl who had been suffering from a hole in the heart since birth. After dropping her body temperature, the team had ten minutes to work while the heart pump dramatically slowed. Shutting the heart's inflow of blood to empty it out, the doctors cut into the heart, sewed up the whole and brought the body's temperature back up. The operation gave the girl a new lease of life.

MR WASHKANSKY TRIES OUT A NEW HEART

The first heart transplant operation was performed on December 3, 1967 at the Groote Schuur Hospital, Cape Town, South Africa on Mr Louis Washkansky, aged 55 who received the heart of a 23-year-old woman killed in a car accident. The surgeon who performed the operation, Christiaan Barnard, a surgical pioneer changed medical history overnight. "On Saturday, I was a surgeon in South Africa, very little known. On Monday, I was world renowned." But eighteen days later, Mr Washkansky's body rejected the organ and he died of pneumonia.

THE YOUNGEST PATIENT TO RECEIVE A NEW HEART

Since then, medicine has moved forward, even attempting a transplant on a newborn baby. In 1996, at the Jackson Children's Hospital in Miami, Florida, baby Cheyenne Pyle was born with hypoplastic left heart syndrome. The condition stopped her heart from pumping blood around her body. Despite receiving a tiny donor heart the infant did not survive the transplant.

GIVING LIFE

Did you know that in the UK today over 6,000 people are awaiting organ transplants? Most are waiting for vital organs such as kidneys, hearts, lungs and livers. However, less than 3,000 transplants are performed every year, which means one in ten patients awaiting transplants will die while on the waiting list. In 2003 alone, 400 people died while waiting. You can donate 25 different organs and tissues: everything from kidneys, pancreas, intestine, liver, lungs and heart to bone and cartilage, bone marrow and corneas. However, doctors can't take organs without the donor's family's consent. And then only when the donor is officially brain dead after the blood supply has been cut off. http://www.uktransplant.org.uk